MIAMI, Fla. (Ivanhoe Newswire) — Young athletes who play contact sports are at risk for a debilitating back injury. Now a new, minimally invasive procedure is helping them recover and get back in the game. PARS Procedure
Nick Mucerino’s passion has always been hockey.
“My mom took me to a lot of the games and I kinda just developed a love for the sport,” Mucerino said.
But after a big hit on the ice, the 16-year-old started feeling severe pain in his lower back.
“The way I can describe it is somebody taking an ice pick down your spine,” Mucerino told Ivanhoe.
Turns out Mucerino suffered a pars fracture.
Allan D Levi MD, PhD, FACS, Professor and Chairman of Neurosurgery at the University of Miami Miller School of Medicine explained, “The pars is a part of your spine. It can be fractured after repetitive stress and strain, particularly after sports.”
It’s a common injury in young athletes who play football, soccer, hockey or ballet.
Dr. Levi said, “In fact, some of the fractures will actually heal on their own.”
But when Mucerino’s injury didn’t improve after six months of physical therapy, he was offered a unique procedure.
“It’s a technique where you basically use a minimally invasive approach to put screws across the fracture site,” Dr. Levi said.
Dr. Levi developed the procedure that uses two small incisions.
“We put a pin through the fracture. Then we get an intraoperative cat scan to make sure the pin is exactly where we want it to be,” he explained.
Screws are placed across the fractured bone to promote fusion. Six months after his surgery, Mucerino was ready to get back on the ice. Now enrolled in law school, nick still loves to get in the rink and play. His back pain is gone.
“It hasn’t limited me in any way,” Mucerino said.
Dr. Levi says there is less blood loss and less dissection of the spine muscles so patients have less pain. Most patients go home the next day after surgery and undergo about three months of physical therapy.
Contributors to this news report include: Janna Ross, Field Producer; Judy Reich, Videographer; Cyndy McGrath, Supervising Producer; Roque Correa, Editor.
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TOPIC: PARS PROCEDURE FOR YOUNG ATHLETES
REPORT: MB #4676
BACKGROUND: Spondylolysis is a spinal fracture of a bone structure called the pars interarticularis, which connects the facet joints of the spine. The spinal cord is protected by rings of bone that make up the middle and posterior portion of the spinal column. In each of these rings, the pars interarticularis (or simply “pars” for short) connects other components of the ring, known as the pedicle and lamina. Spondylolysis (sometimes called by the shortened name, “pars fracture”) usually occurs during childhood or adolescence from repetitive stress, rather than from an acute injury. In other words, it is usually a stress fracture rather than a sudden break. This is a common condition of children and teenagers who are involved in organized sports. Active kids and teens with spondylolysis may experience symptoms. However, some people with this condition may not develop symptoms until later in adulthood.
TREATMENT: Initial treatment is almost always nonsurgical in nature. Most patients with spondylolysis will improve with nonsurgical treatment. Nonsurgical treatment may include rest, NSAIDs such as ibuprofen and naproxen, physical therapy, and bracing. Surgery may be recommended for patients who have severe or high-grade slippage, slippage that is progressively worsening, or back pain that has not improved after a period of nonsurgical treatment.
NEW TECHNOLOGY: Allan D Levi MD, PhD, FACS, Professor and Chairman of Neurosurgery at the University of Miami Miller School of Medicine talked about the pars procedure he developed, “Essentially we make two small incisions. And we use X-ray – or fluoroscopy – to localize where the fracture is. And we put a pin through the fracture. Then we get an intraoperative CAT scan to make sure that the pin is exactly where we want it to be. And then we put a screw across the fracture site along the pin. And then the other thing that we do is that the screws are only good to stabilize the fracture. We add some protein to help fusion, as well as some bone graft inside the fracture. And that’s done through another tiny separate incision.” Dr. Levi says patients who have a lot of arthritis of the spine are not good candidates. X-rays may miss initial diagnosis. He recommends doctors perform a CAT scan to see the fracture. For more information on the pars procedure go to http://med.miami.edu/news/unique-surgery-helps-young-athletes-with-spinal-fractures.
(Source: Allan D Levi MD, PhD, FACS)
FOR MORE INFORMATION ON THIS REPORT, PLEASE CONTACT:
Kai Hill, University of Miami Miller School of Med. PR
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